Neuro Flashcards
Pain
acute or chronic-spinal disc disease, trigeminal neualgia, neuropathic, degenerative
HA and migraine
may indicate organic disease, stress response, vasodilation, skeletal muscle tension, or combination of factors
Seizures
alteration in sensation, behavior, movement, perception, or consciousness
Dizziness and Vertigo
sensation of imbalance or movement
Level of consciousness
evaluated clinically as the patients ability to respond appropriately to stimuli
Mental status
orientation, short and long term memory, appearance, and behavior
Language ability
can patient communicate through speech and writing
Aphasia
deficiency in language function
Agnosia
inability to interpret or recognize objects seen through the special senses (visual and tactile)
- “what do you do with a pencil”
- “what is this object?”
Motor
requires ability to understand and normal motor strength
Glasgow Coma Scale
assessing response to stimuli
CT scan
cross sectional images of the cranial cavity; may use contrast media
MRI
cross-sectional images of cranial cavity using megnets; contrast may be used
PET and SPECT scans
nuclear medicine procedure that produce 3 dimensional images
Cerebral Angiogram
visualization of the cerebral blood vessels
altered level of consciousness
apparent in the patient who is not oriented, does not follow commands, or needs persistent stimuli to achieve a state of alertness
LOC
on a continuum from normal alertness and cognition to coma
Coma
unconsciousness, unarousable unresponsiveness
Head CT without contrast
determining if intracranial bleed
CXR
may be prone to aspiration and pneumonias
Labs to look at
CBC, glucose, electrolytes, osmolality
What does a patient look like with intracranial pressure
- limited space for skull expansion secondary to volume change in brain tissue, blood or CSF
- pupillary changes and impaired extraocular movements
- weakness in one extremity or one side
- Constant headache that increases in intensity
what is the medical management to decrease cerebral edema?
- osmotic diuretics: MANNITOL to dehydrate the brain tissue and reduce cerebral edema
- hypertonic saline
- fluid restriction
- lowering body temperature: reducing the oxygen and metabolic requirements of the brain
- seizure prophylaxis
Nursing interventions
- Maintain airway
- Maintaining fluid status
- Managing nutritional needs
- Maintaining skin and joint integrity
- Maintaining body temperature
- Promoting Bowel and bladder function
- Sensory Stimulation and Communication
Seizures
are abrupt, abnormal, excessive and uncontrolled electrical discharge of neurons within the brain
Epilepsies
group of syndromes, characterized by unprovoked, recurring seizures, classified by specific patterns of clinical features
What could cause a seizure
- extreme stress
- overwhelming fatigue
- acute alcohol ingestion
- Exposure to flashing lights
- Cocaine, aerosols, inhaling glue
Lab and diagnostic tests
- alcohol and illicit drug screen
- EEG and MRI
Interventions during a seizure
- protect from injury
- maintain airway and reduce aspiration risk, but do not restrain or open jaw to insert airway
- Document onset and duration of seizure
- findings prior to seizure, LOC, apnea, cyanosis, motor activity, incontinence
Interventions after a seizure
- document events leading to, occuring during and after
- side lying position
- assess for injuries, neuro checks, VS
- Reorient
- Initiate seizure precautions
Medical management Pharmacology
- not curative, but control with minimal side effects
- selected on basis of seizure type
- Do not stop abruptly
- Example: Tegretol, Klonopin, Neurontin, Dilatin
Medical management
Surgical
- If intracranial tumor, abscess, cyst
- Microsurgical: EEG with depth electrodes, electrocortical mapping, implanted generator
Referrals
- Social service for obtaining medications
- Coping and reducing fear of seizures
- Discrimination on the diagnosis of epilepsy is illegal
